American Society of Hirudotherapy

Microvascular salvage of a thrombosed total ear replant

Case report published in Microsurgery (2013)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Case reportClinical TrialsSenchenkov A, Jacobson SR · Microsurgery, 2013

Abstract

Microvascular replantation, when possible, is the treatment of choice for total ear amputations. Both arterial and venous reconstruction should be attempted. The present case report describes a successful total ear replantation in a 45-year-old woman whose ear was amputated due to a horse accident. Venous thrombosis subsequently occurred and was managed with anticoagulation and leech therapy. Eighty hours after the replantation, arterial thrombosis took place. The posterior auricular artery thrombosed anastomosis was resected and reconstructed with an interposition vein graft. This report illustrates the feasibility of the successful microvascular salvage of a thrombosed total ear replant. It suggests the need for close clinical monitoring of the replanted ear and prompt microvascular reexploration in an event of the loss of arterial flow.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeCase ReportsJournal Article
Indexed MeSH termsAmputation, TraumaticEar AuricleFemaleHumansMicrosurgeryMiddle AgedPostoperative ComplicationsReplantationSaphenous VeinThrombosisVascular Grafting

Summary

Successful total ear replantation in a 45-year-old woman after horse accident. Venous thrombosis was managed with anticoagulation and leech therapy; subsequent arterial thrombosis required reanastomosis with interposition vein graft.

Why This Matters for Hirudotherapy

This case report describes successful total ear replantation in a 45-year-old woman following horse-related trauma, complicated by venous thrombosis and subsequent arterial thrombosis. Venous thrombosis was managed with anticoagulation and leech therapy. Eighty hours after replantation, arterial thrombosis occurred, requiring resection and reconstruction of the posterior auricular artery thrombosed anastomosis with an interposition vein graft. For ASH's domain, this case documents leech therapy used as part of the management of venous thrombosis following ear replantation. The honest caveat is that this is a single case report, and the abstract does not provide details on leech therapy duration, protocol, or outcomes specific to leeching. The report describes a sequential series of events and cannot establish leech efficacy or causation between the interventions and outcomes.

Citation

Microvascular salvage of a thrombosed total ear replant.

Senchenkov A, Jacobson SR · Microsurgery, 2013

Added to ASH library: May 26, 2026 · Site last updated: June 18, 2026

This website provides educational information and does not constitute medical advice, diagnosis, or treatment recommendations. Medicinal leech therapy carries clinically meaningful risks and should be performed only by qualified clinicians under institutionally approved protocols. FDA 510(k) clearance for medicinal leeches is limited to specific indications; investigational and off-label discussions are labeled accordingly. For patient-specific guidance, consult a qualified healthcare provider.